Long-term impact and clinical significance of living donor liver transplantation with respect to donor liver restoration and spleen size: a prospective study.

This study aimed to evaluate postoperative long-term liver restoration and splenic enlargement and their clinical significance in living donor liver transplantation. One hundred and sixteen donors who had donated livers more than 5 years previously accepted the invitation to participate in this study. The liver restoration rate and the splenic enlargement rate were calculated as the rate with respect to the original volume. The mean liver restoration rate was 0.99 +/- 0.12 and older age was associated with a higher incidence for liver restoration rate <0.95 (P = .005), whereas type of donor operation was not. The donors with liver restoration rate <0.95 showed lower serum albumin levels than those with liver restoration rate >= 0.95. The mean splenic enlargement rate was 1.10 +/- 0.16. Right lobe donors demonstrated higher splenic enlargement rate (1.14 +/- 0.18) than left lobe/lateral segment donors (1.06 +/- 0.13). In the donors with splenic enlargement rate >= 1.10, platelet count was not fully restored to the preoperative level. In conclusion, older age increases the risk for incomplete postoperative liver restoration, which may be associated with a decrease in albumin more than 5 years after donation. Right lobe donation poses a risk of splenic enlargement, which is associated with incomplete restoration of platelet count.